Disclosures: Talya K. Fleming, MD: No financial relationships or conflicts of interest

Objective: Most stroke survivors are discharged with insufficient specialized follow-up or access to secondary stroke prevention programs, resulting in a high incidence of recurrent stroke and hospital readmissions. The objectives of this study were to: 1) assess the feasibility of implementing early physiatrist-directed stroke risk factor education based on multiple national guidelines, and 2) investigate if this education improves long-term patient outcome.

Design: Retrospective cohort study.Setting : Outpatient practice, suburban, academic medical center.Participants : Post-discharge from an inpatient rehabilitation facility, adult stroke survivors were enrolled in a comprehensive outpatient stroke recovery program.

Interventions: The intervention included: physiatrist-directed medical evaluation/management and individualized stroke risk factor education focused on modifiable risk factors to reduce the recurrence of stroke. The easy-to-use educational content was designed by integrating professional guidelines established by the American Heart Association/American Stroke Association, The Joint Commission, and the Centers for Disease Control and Prevention.

Main Outcome Measures: Stroke survivor responses for physical activity, nutrition, smoking status, knowledge of warning signs of stroke, emergency management and mood assessment were collected at 30-day intervals following stroke diagnosis (30-days, 60-days, 90-days, and 120-days).

Results: 200 patients were enrolled in the outpatient stroke recovery program. Following completion of the 3 to 4-month follow-up period, initially elevated blood lipid (LDL-C) and hemoglobin A1C (HbA1C) levels showed significant improvements (P < 0.01). Scores in other risk factor education categories (physical activity, nutrition, warning signs and emergency management of signs) also saw substantial improvement. The program had a 66% completion rate and received positive feedback from stroke survivors and clinicians.Conclusions: Succinct clinical implementation of risk factor education after stroke is feasible in an outpatient clinical setting. Individualized education notably improves stroke survivor compliance with national guidelines for LDL-C and HbA1C levels, physical activity, nutrition, and knowledge of warning signs. Future randomized studies could elucidate the significance of these effects and their relationship with clinical outcomes after stroke.

Level of Evidence: Level III

« Back to AAPM&R Annual Assembly 2021

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/early-clinical-implementation-of-risk-factor-education-and-physiatrist-follow-up-in-stroke-survivors-a-feasibility-study/